The Experts below are selected from a list of 141 Experts worldwide ranked by ideXlab platform
John P. Carey - One of the best experts on this subject based on the ideXlab platform.
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can vestibular evoked myogenic potentials help differentiate Meniere Disease from vestibular migraine
Otolaryngology-Head and Neck Surgery, 2012Co-Authors: Geraldine M Zuniga, Kristen L Janky, Michael C Schubert, John P. CareyAbstract:Objectives. To characterize both cervical and ocular vestibular-evoked myogenic potential (cVEMP, oVEMP) responses to air-conducted sound (ACS) and midline taps in Meniere Disease (MD), vestibular ...
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polymorphisms in kcne1 or kcne3 are not associated with Meniere Disease in the caucasian population
American Journal of Medical Genetics Part A, 2010Co-Authors: Colleen A Campbell, Oluwaseun A Myrie, Charles Coleman Della Santina, Nancy Smith, Nicole C Meyer, Joseph A Califano, Edwin M. Stone, K Fukushima, John P. CareyAbstract:Meniere Disease (MD) is a complex disorder of unknown etiology characterized by the symptom triad of vertigo, sensorineural hearing loss, and tinnitus. Its reported incidence is 1–2 per 1,000 in Caucasians and 0.03–0.37 per 1,000 in Japanese. Doi et al. [Doi et al. (2005); ORL J Otorhinolaryngol Relat Spec 67:289–293] recently reported that two single nucleotide polymorphisms (SNPs) in KCNE1 and KCNE3 are associated with MD in Japanese subjects. Consistent with this possibility, these two genes encode potassium channels that are expressed in the stria vascularis and endolymphatic sac, respectively, and their role in ion transport suggests that they may be important in inner ear homeostasis. To establish whether a similar association exists in the Caucasian MD population, we sequenced the coding regions and exon–intron boundaries of both genes in 180 Caucasian persons with MD and 180 matched Caucasian controls. Neither of the two reported SNPs was significantly associated with MD when compared to the Caucasian controls (KCNE1, P = 0.55; KCNE3, P = 0.870). Comparison of allele frequencies between the Japanese MD population and our study population revealed no significant difference between groups (KCNE1, P = 0.90; KCNE3, P = 0.862), suggesting that the significant differences reported in the Japanese study arose from their control population. Six additional SNPs in both KCNE1 and KCNE3 were genotyped and none was associated with MD. Population stratification within our MD and Caucasian control population was excluded. Our data show that SNPs in KCNE1 and KCNE3 are not associated with MD in Caucasians. © 2009 Wiley-Liss, Inc.
John G Frazee - One of the best experts on this subject based on the ideXlab platform.
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two handed endoscopic directed vestibular nerve sectioning case series and review of the literature
Journal of Neurosurgery, 2012Co-Authors: Aaron R. Cutler, Sean W Kaloostian, Akira Ishiyama, John G FrazeeAbstract:Object Vestibular nerve sectioning is an accepted surgical treatment option for patients with medically refractory Meniere Disease. In this paper the authors introduce and evaluate a 2-handed endoscopic-directed technique for vestibular nerve section. Methods Eleven patients underwent a retrosigmoid craniectomy for endoscopic-directed vestibular nerve sectioning as treatment for intractable vertigo associated with Meniere Disease. In all patients, identification and dissection of the cranial nerve VII/VIII complex was performed entirely under endoscopic guidance. The authors used the specially designed Frazee II neuroendoscope, consisting of a traditional endoscope lens with a microsuction attachment. Results Vestibular nerve sectioning was completed in all 11 patients. Postoperative improvement in vertiginous episodes was achieved in 10 patients (91%). Auditory function was noted to be worse postoperatively in only 1 patient (9%). The same patient also developed a House-Brackmann Grade III facial nerve p...
Lidia Frejo - One of the best experts on this subject based on the ideXlab platform.
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Proinflammatory cytokines and response to molds in mononuclear cells of patients with Meniere Disease
Nature Publishing Group, 2018Co-Authors: Lidia Frejo, Alvaro Gallego-martinez, Juan Manuel Espinosa-sanchez, Teresa Requena, Eduardo Martin-sanz, Juan Carlos Amor-dorado, Andres Soto-varela, Sofia Santos-perez, Angel Batuecas-caletrio, Ismael AranAbstract:Abstract Epidemiological studies have found a higher prevalence of allergic symptoms and positive prick tests in patients with Meniere’s Disease (MD); however the effect of allergenic extracts in MD has not been established. Thus, this study aims to determine the effect of Aspergillus and Penicillium stimulation in cytokine release and gene expression profile in MD. Patients with MD showed higher basal levels of IL-1β, IL-1RA, IL-6 and TNF-α when compared to healthy controls. We observed that IL-1β levels had a bimodal distribution suggesting two different subgroups of patients, with low and high basal levels of cytokines. Gene expression profile in peripheral blood mononuclear cells (PBMC) showed significant differences in patients with high and low basal levels of IL-1β. We found that both mold extracts triggered a significant release of TNF-α in MD patients, which were not found in controls. Moreover, after mold stimulation, MD patients showed a different gene expression profile in PBMC, according to the basal levels of IL-1β. The results indicate that a subset of MD patients have higher basal levels of proinflammatory cytokines and the exposure to Aspergillus and Penicillium extracts may trigger additional TNF-α release and contribute to exacerbate inflammation
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extended phenotype and clinical subgroups in unilateral Meniere Disease a cross sectional study with cluster analysis
Clinical Otolaryngology, 2017Co-Authors: Lidia Frejo, Andres Sotovarela, Sofia Santosperez, Ismael Aran, Eduardo Martinsanz, Roberto Teggi, Gabriel Trinidad, R Manrique, Nicolas Perez, M S AlmeidabrancoAbstract:Objectives To define clinical subgroups by cluster analysis in patients with unilateral Meniere Disease (MD) and to compare them with the clinical subgroups found in bilateral MD. Design A cross-sectional study with a two-step cluster analysis. Settings A tertiary referral multicenter study. Participants Nine hundred and eighty-eight adult patients with unilateral MD. Main outcome measures: best predictors to define clinical subgroups with potential different aetiologies. Results We established five clusters in unilateral MD. Group 1 is the most frequently found, includes 53% of patients, and it is defined as the sporadic, classic MD without migraine and without autoimmune disorder (AD). Group 2 is found in 8% of patients, and it is defined by hearing loss, which antedates the vertigo episodes by months or years (delayed MD), without migraine or AD in most of cases. Group 3 involves 13% of patients, and it is considered familial MD, while group 4, which includes 15% of patients, is linked to the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by a comorbid AD. We found significant differences in the distribution of AD in clusters 3, 4 and 5 between patients with uni- and bilateral MD. Conclusions Cluster analysis defines clinical subgroups in MD, and it extends the phenotype beyond audiovestibular symptoms. This classification will help to improve the phenotyping in MD and facilitate the selection of patients for randomised clinical trials.
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clinical subgroups in bilateral Meniere Disease
Frontiers in Neurology, 2016Co-Authors: Lidia Frejo, Andres Sotovarela, Sofia Santosperez, Ismael Aran, Angel Batuecascaletrio, Vanesa Perezguillen, Herminio Perezgarrigues, Jesus Fraile, Eduardo Martinsanz, Maria C TapiaAbstract:Meniere Disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms and tinnitus associated with several comorbidities such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5-50% and it depends on the duration of the Disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of bilateral MD and to develop new treatments. We have defined five clinical variants in bilateral MD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to bilateral MD.
Akira Ishiyama - One of the best experts on this subject based on the ideXlab platform.
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blood labyrinth barrier permeability in Meniere Disease and idiopathic sudden sensorineural hearing loss findings on delayed postcontrast 3d flair mri
American Journal of Neuroradiology, 2016Co-Authors: Michael N Pakdaman, Akira Ishiyama, Gail Ishiyama, Kevin A Peng, Hyun J Kim, W B Pope, Ali R SepahdariAbstract:BACKGROUND AND PURPOSE: Meniere Disease and idiopathic sudden sensorineural hearing loss can have overlapping clinical presentation and may have similar pathophysiology. Prior studies using postcontrast 3D-FLAIR MR imaging suggest abnormal blood-labyrinth barrier permeability in both conditions, but the 2 Diseases have not been directly compared by using the same imaging techniques. We hypothesized that delayed postcontrast 3D-FLAIR MR imaging would show differences in blood-labyrinth barrier permeability between Meniere Disease and idiopathic sudden sensorineural hearing loss. MATERIALS AND METHODS: Patients with unilateral Meniere Disease ( n = 32) and unilateral idiopathic sudden sensorineural hearing loss ( n = 11) imaged with delayed postcontrast 3D-FLAIR MR imaging were retrospectively studied. Signal intensities of the medulla and perilymph of the cochlear basal turns of both ears in each patient were measured in a blinded fashion. Cochlea/medulla ratios were calculated for each ear as a surrogate for blood-labyrinth barrier permeability. The ears were segregated by clinical diagnosis. RESULTS: Cochlea/medulla ratio was higher in symptomatic ears of patients with Meniere Disease (12.6 ± 7.4) than in patients with idiopathic sudden sensorineural hearing loss (5.7 ± 2.0) and asymptomatic ears of patients with Meniere Disease (8.0 ± 3.1), indicating increased blood-labyrinth barrier permeability in Meniere Disease ears. The differences in cochlea/medulla ratio between symptomatic and asymptomatic ears were significantly higher in Meniere Disease than in idiopathic sudden sensorineural hearing loss. Asymptomatic ears in patients with Meniere Disease showed higher cochlea/medulla ratio than symptomatic and asymptomatic ears in patients with idiopathic sudden sensorineural hearing loss. CONCLUSIONS: Increased cochlea/medulla ratio indicates increased blood-labyrinth barrier permeability in Meniere Disease compared with idiopathic sudden sensorineural hearing loss. Increased cochlea/medulla ratio in asymptomatic ears of patients with Meniere Disease also suggests an underlying systemic cause of Meniere Disease and may provide a pathophysiologic biomarker.
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two handed endoscopic directed vestibular nerve sectioning case series and review of the literature
Journal of Neurosurgery, 2012Co-Authors: Aaron R. Cutler, Sean W Kaloostian, Akira Ishiyama, John G FrazeeAbstract:Object Vestibular nerve sectioning is an accepted surgical treatment option for patients with medically refractory Meniere Disease. In this paper the authors introduce and evaluate a 2-handed endoscopic-directed technique for vestibular nerve section. Methods Eleven patients underwent a retrosigmoid craniectomy for endoscopic-directed vestibular nerve sectioning as treatment for intractable vertigo associated with Meniere Disease. In all patients, identification and dissection of the cranial nerve VII/VIII complex was performed entirely under endoscopic guidance. The authors used the specially designed Frazee II neuroendoscope, consisting of a traditional endoscope lens with a microsuction attachment. Results Vestibular nerve sectioning was completed in all 11 patients. Postoperative improvement in vertiginous episodes was achieved in 10 patients (91%). Auditory function was noted to be worse postoperatively in only 1 patient (9%). The same patient also developed a House-Brackmann Grade III facial nerve p...
Adolfo M Bronstein - One of the best experts on this subject based on the ideXlab platform.
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vertigo as a migraine trigger
Neurology, 2009Co-Authors: Louisa Murdin, Rosalyn Davies, Adolfo M BronsteinAbstract:Background: It is reported in some individual patients that vestibular stimuli can trigger migraine attacks. This study used a case-control design to examine systematically the hypothesis that vertigo induced by vestibular stimulation (rotation/caloric testing) can act as a specific migraine trigger. Methods: A total of 123 new patients attending neuro-otology or neurology clinics were studied with questionnaires and physician interview to ascertain migraine history according to International Headache Society criteria. A total of 79 who underwent rotation/caloric vestibular testing (test group) were compared with 44 control patients in whom no such testing was carried out (control group). The principal outcome measure was the occurrence of a migraine attack within 24 hours of exposure to vestibular stimulation. Results: Of those participants with a past history of migraines, 19/39 (49%) of the test group experienced a migraine in the study time window, compared with 1/21 (5%) of the control group. Binary logistic regression analysis confirmed that vestibular testing was associated ( p Conclusions: The results indicate that induced vertigo can act as a migraine trigger, a finding with implications for the diagnosis of patients with episodic vertigo and migraine headache. While such patients may well have basilar migraine or migrainous vertigo, alternatively, another disorder causing episodic vertigo (e.g., benign paroxysmal positional vertigo or Meniere Disease) may be triggering migraine headaches.